Discover and read the best of Twitter Threads about #cvCoag
Most recents (3)
1a) Welcome to a new #accredited #tweetorial on the management of aFXa-DOAC-associated #hemorrhage and specifically the role of coag laboratory testing in these challenging cases. 
1b) Our expert author is #pharmacist Craig Beavers, PharmD @beaverspharmd CV Clinical Pharmacy Specialist @UK_COP, and Immediate Past Chair of the @ACCinTouch #ACCCVT Section
2) This 🆓program is accredited for 0.5h CE/#CME for #physicians #physicianassociates #nurses #nurespractitioners #pharmacists and is supported by a grant from AstraZeneca. See statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/.
So much research has been done on management of warfarin before and after procedures. But direct oral anticoagulants are more commonly prescribed. How is bleeding risk similar or different between DOAC- and warfarin-treated patients? 🧵
DOACs have a shorter half-life than warfarin. So they don’t require “bridging” with heparin. Warfarin has a long half-life, so sometimes we give bridging heparin… but that’s becoming less and less common.
When warfarin was held and no bridging heparin was given, patients had lower perioperative bleeding rates than when DOACs were used.
Have you seen the newest perioperative #cvCoag guidelines from @accpchest? I've had some time to digest this exciting new document and wanted to share a few take away points. pubmed.ncbi.nlm.nih.gov/35964704/
First big recommendation that might catch folks off guard: For patients with mech valve and VKA use, "we suggest against heparin bridging". Will this be a big change for your practice? How to implement and get buy-in from clinicians & patients?
A series of recommendations basically endorse the PAUSE protocol of stoping DOACs 1-2 days pre-op (depend on bleeding risk). Dabigatran may need longer hold if low CrCl. No bridging heparin needed for DOAC-treated patients.
